# SAMARITAN DAYTOP VILLAGE, INC. SECTION 125 PLAN

Health and welfare plan sponsored by **SAMARITAN DAYTOP VILLAGE, INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | SAMARITAN DAYTOP VILLAGE, INC. |
| EIN | 112635374 |
| Plan number | 502 |
| Plan year | 2025 |
| Location | BRIARWOOD, NY |
| Industry | non-profit organization management |
| Funding | fully insured |
| Total premiums | $10.4M |
| Participants | 1,424 |
| Persons covered | 1,635 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| EMBLEMHEALTH | Health, Rx |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Life, LTD, Other |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Dental, Vision, Indemnity |
| TRANSAMERICA LIFE INSURANCE COMPANY | Life, STD, Other |
| NATIONAL HEALTH INSURANCE COMPANY | Other |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Other |

## Brokers

| Broker | Placed with |
|---|---|
| ONE GROUP NY INC | EMBLEM HEALTH |
| PROFESSIONAL GROUP PLANS INC | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA |
| USI INSURANCE SERVICES LLC | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA |
| ONE GROUP NY INC | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES |
| PROFESSIONAL GROUP PLANS INC | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES |
| PREMIER WORK-SITE SOLUTIONS | TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY |
| ONE GROUP INC | TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY |
| M3 TECHNOLOGY LLC | TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY |
| PREMIER WORKSITE SOLUTIONS INC | FIRST UNUM LIFE INSURANCE COMPANY |
| ONE GROUP INC | FIRST UNUM LIFE INSURANCE COMPANY |
| USI INSURANCE SERVICES LLC | FIRST UNUM LIFE INSURANCE COMPANY |

## About this data

- Source: public Form 5500 filings from the U.S. Department of Labor (EBSA), rebuilt on each DOL release.
- Full page (charts, history, peer benchmarks, fees, contacts): https://planoptica.com/welfare/112635374-502
- Cite as: PlanOptica, https://planoptica.com/welfare/112635374-502
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